摘要
目的调查成都市社区管理高血压患者经济指标及管理效果,评估其影响因素,为进一步探索适宜的社区高血压管理模式提供科学依据。方法抽取成都市农村、城郊结合部及城市社区3个,随机选取在社区进行高血压建档及管理1年以上,符合纳入标准的624例高血压患者(管理组)行问卷调查。同期在上述3个社区进行的≥18岁的常住(≥1年)居民基线调查中筛查的1345例高血压患者作为对照组。结果纳入社区的高血压患者血压管理显著优于对照组(治疗率78.6%vs 32.9%,血压控制率62.2%vs 7.1%,联合用药率44.4%vs 21.8%,P=0.000)。社区高血压患者61.3%的家庭人均收入≤999元/月,78.8%的患者年均医疗支出<1000元/年,84.4%的患者高血压治疗支出<100元/月。高血压患者的血压控制与受教育程度、医疗保险、报销比例、就诊频率呈正相关,与月家庭人均收入、每月高血压诊治费用、高血压病程呈负相关。结论社区高血压规范管理有助于提高患者血压治疗率和控制率,但社区高血压患者普遍收入偏低,医疗支出不足,可能影响血压控制。未来应该优化高血压社区随访,大力普及患者教育,提高患者就诊频率;同时增加医疗保障,推广价廉效优的保底治疗方案,以保障基层群众高血压病的治疗。
Objective To provide scientific basis for further exploring the appropriate management model of hyper- tension in community management of hypertension patients in Chengdu by investigating the relationship between economic indicators and blood pressure management effect. Methods Three communities of city, rural, suburban of Chengdu were selected. 624 hypertension patients who were archiving and management for more than 1 year were randomly selected as management group and 1345 hypertension patients at the same period were selected as control （control group）. Results The blood pressure management of management group was significantly better than that of the control group （treatment rate 78.6o/00 vs 32.9~//0, blood pressure control rate 62.2~//oo vs 7.1~//0, combined drug use rate 44.4~/oo vs 21.8~ P=0. 000）. 61.3~ of the community hypertension patients per capita income was 4999 Yuan/month. 78.80//oo of the patients the annual medical expenditure was %1000 Yuan/year. 84.40//00 of the patients the hypertension treatment ex- penditure was % 100 Yuan/month. Blood pressure control in hypertensive patients was positively related with the educa- tion, medical insurance, reimbursement ratio and frequency of treatment, and was negatively related to monthly family income per capita, the monthly cost of hypertension treatment and the disease course of the disease. Conclusion Community management of hypertension is helpful to improve blood pressure treatment and control rate, but the low income and medical expenses might affect blood pressure control. The future should optimize the community hypertension follow-up, promote patient health educationto improve the compliance of patients.
出处
《西部医学》
2017年第3期367-370,共4页
Medical Journal of West China
基金
成都市科技惠民项目(2015-HM02-00049-SF)
关键词
高血压
社区管理
经济指标
Hypertension
Community managed
Economic indicators
